Prognostic Impact of the Symptom of New-Onset Atrial Fibrillation in Acute Myocardial Infarction: Insights From the NOAFCAMI-SH Registry

• DOI: 10.3389/fcvm.2021.677695
• Publication Date: 2021-09-22T04:59:27Z
• Authors: Jiachen Luo; Baoxin Liu; Hongqiang Li; Siling Xu; Mengmeng Gong; Zhiqiang Li; Xiaoming Qin; Beibei Shi; Chuanzhen Hao; Ji Zhang; Yidong Wei
• Keywords: acute myocardial infarction; heart failure; Cardiovascular Medicine; symptom; mortality; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; RC666-701; ischemic stroke; Diseases of the circulatory (Cardiovascular) system; atrial fibrillation

Background: New-onset atrial fibrillation (NOAF) is a common complication during acute myocardial infarction (AMI) and sometimes can be completely asymptomatic, but the clinical implications of these asymptomatic episodes require further characterization. The objective this study was to investigate short- long-term prognostic impact post-MI NOAF based on presence AF-related symptoms. Methods: New-Onset Atrial Fibrillation Complicating Acute Myocardial Infarction in ShangHai (NOAFCAMI-SH) registry retrospective cohort including participants with AMI without documented history AF. Patients were divided into two groups according primary endpoint all-cause mortality. Results: Of 2,399 patients included, 278 (11.6%) developed whom 145 (6.0%) 133 (5.5%) symptomatic ones. During hospitalization, 148 died [106, 10, 32 sinus rhythm (SR), groups, respectively]. After multivariable adjustment, only associated in-hospital mortality [odds ratio (OR): 2.32, 95% confidence interval (CI): 1.36–3.94] compared SR. Over median follow-up 2.7 years, 3.2, 12.4, 11.8% per year SR, respectively. adjustment for confounders, it [hazard (HR): 1.61, CI: 1.09–2.37) rather than one (HR: 1.37, 0.88–2.12) that significantly related Similar results also observed cardiovascular [HRs CI 1.71 (1.10–2.67) 1.25 (0.74–2.11) NOAF, Both heart failure, whereas those at heightened risk ischemic stroke. Our exploratory analysis identified high-burden as highest-risk population (mortality: 19.6% year). Conclusion: Among AMI, poor survival. Registration: URL: https://clinicaltrials.gov/ ; Unique identifier: NCT03533543.